Active NPI
Karla Rae Juvonen, PA
- Physician Assistant
- Hugo, MN
National Provider Identifier
1386680346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 9412
- Practice address
- 14701 Victor Hugo Blvd N
Hugo, MN 55038-4561 - Phone
- (651) 767-1900
- Fax
- (651) 767-1901
- NPI assigned
- Jun 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 9412 | MN | Primary |
Addresses
Primary practice location
14701 Victor Hugo Blvd N
Hugo, MN 55038-4561
Mailing address
8170 33Rd Ave
Ms: 21110Q
Bloomington, MN 55425-4516
Phone (651) 767-1900
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP27780 | Other | MN | HEALTHPARTNERS # |
| 877918000 | Medicaid | MN | |
| 143396 | Other | MN | UCARE # |
Other names 1
- Karla Rae Johanning
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9412 | MN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Phyllis Mandel MD PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- New Rochelle, NY
- NPI 1093977951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150761600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1479168000000",
"number": "1386680346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8170 33RD AVE",
"address_2": "MS: 21110Q",
"city": "BLOOMINGTON",
"state": "MN",
"postal_code": "554254516",
"telephone_number": "651-767-1900",
"fax_number": "651-767-1901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14701 VICTOR HUGO BLVD N",
"city": "HUGO",
"state": "MN",
"postal_code": "550384561",
"telephone_number": "651-767-1900",
"fax_number": "651-767-1901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JUVONEN",
"first_name": "KARLA",
"middle_name": "RAE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-20",
"last_updated": "2016-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MN",
"license": "9412",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHPARTNERS #",
"identifier": "HP27780",
"state": "MN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "877918000",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UCARE #",
"identifier": "143396",
"state": "MN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KARLA",
"last_name": "JOHANNING",
"middle_name": "RAE",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Hugo, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.